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UFCW & EMPLOYERS BENEFIT TRUST FUND: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
UFCW & EMPLOYERS BENEFIT TRUST FUND (EIN 94-6078804)
Tax period
2011-01-01 to 2011-12-31
Filed
2012-11-09
IRS object ID
201203149349302320
Schema version
2011v1.2
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2012-11-09T17:48:23-06:00Timestamp
Tax Period End Date2011-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN300702322EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1HEMMING MORSE CPA'S AND CONSULTANTSBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1160 SPEAR STREET SUITE 1900AddressLine1
CitySAN FRANCISCOCity
StateCAState
ZIP Code94105ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN946078804EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1UFCW & EMPLOYERS BENEFIT TRUSTBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlUFCWNameControl
Phone9257467530Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line11277 TREAT BOULEVARD 10TH FLOORAddressLine1
CityWALNUT CREEKCity
StateCAState
ZIP Code94597ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameRICK A SILVAName
TitleEXECUTIVE DIRECTORTitle
Phone9257467530Phone
Date Signed2012-11-09DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
PTINP00739466PTIN
Phone4158364000Phone
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonRICK A SILVANameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line11277 TREAT BOULEVARD 10TH FLOORAddressLine1
CityWALNUT CREEKCity
StateCAState
ZIP Code94597ZIPCode
FieldValueIRS element (for citing)
Gross Receipts909993370GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501cXOrganization501c
Web SiteN/AWebSite
Type Of Organization TrustXTypeOfOrganizationTrust
Year Formation1962YearFormation
State Legal DomicileCAStateLegalDomicile
Activity Or Mission DescriptionTO PROVIDE HEALTH AND WELFARE BENEFITS TO ELIGIBLE PARTICIPANTS.ActivityOrMissionDescription
Nbr Voting Members Governing Body13NbrVotingMembersGoverningBody
Nbr Independent Voting Members13NbrIndependentVotingMembers
Total Nbr Employees0TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year0ContributionsGrantsPriorYear
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year470768034ProgramServiceRevenuePriorYear
Program Service Revenue CY512070088ProgramServiceRevenueCY
Investment Income Prior Year3576079InvestmentIncomePriorYear
Investment Income Current Year1379887InvestmentIncomeCurrentYear
Other Revenue Prior Year12462519OtherRevenuePriorYear
Other Revenue Current Year21960219OtherRevenueCurrentYear
Total Revenue Prior Year486806632TotalRevenuePriorYear
Total Revenue Current Year535410194TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year547101315BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY522424333BenefitsPaidToMembersCY
Salaries Etc Prior Year0SalariesEtcPriorYear
Salaries Etc Current Year0SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year35082942OtherExpensePriorYear
Other Expenses Current Year36364876OtherExpensesCurrentYear
Total Expenses Prior Year582184257TotalExpensesPriorYear
Total Expenses Current Year558789209TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-95377625RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-23379015RevenuesLessExpensesCY
Total Assets BOY328995686TotalAssetsBOY
Total Assets EOY280170224TotalAssetsEOY
Total Liabilities BOY152673392TotalLiabilitiesBOY
Total Liabilities EOY128404933TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY176322294NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY151765291NetAssetsOrFundBalancesEOY
Mission DescriptionNONEMissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
DescriptionTO PROVIDE HEALTH AND WELFARE BENEFITS TO ELIGIBLE PARTICIPANTS COVERED UNDER THE COLLECTIVE BARGAINING AGREEMENTS BETWEEN THE UNION AND THE EMPLOYERS.Description
Described In501 C30DescribedIn501C3
Schedule B Required0ScheduleBRequired
Political Activities0PoliticalActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip0ReportLandBldgEquip
Report Invest Oth Securities1ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets1ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote0ReportFin48Footnote
Independent Audit Financial Stmt1IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt0ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required0ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With10965138NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees0NumberOfEmployees
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members13NbrVotingGoverningBodyMembers
Number Independent Voting Members13NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties1DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons0AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement0RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO0CompensationProcessCEO
Compensation Process Other0CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1ROBERT WESTBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number9257467530TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11277 TREAT BLVD 10TH FLOORAddressLine1
CityWALNUT CREEKCity
StateCAState
ZIP Code94597ZIPCode
FieldValueIRS element (for citing)
No Listed Persons CompensatedXNoListedPersonsCompensated

Form990 Part VII Section A Form990PartVIISectionA (13 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensation
JASON BERGGREN
TRUSTEE5.00X000
JAMES V MORGAN
CHAIRMAN5.00X000
TROY DININ
TRUSTEE5.00X000
W ROBERT VALLON
TRUSTEE5.00X000
BRENT BOHN
TRUSTEE5.00X000
JERRY HUNSUCKER
TRUSTEE5.00X000
JACQUES S LOVEALL
SECRETARY5.00X000
SHERYL PERCELL
TRUSTEE5.00X000
MICHAEL A BORSTEL
TRUSTEE5.00X000
KIRK L VOGT
TRUSTEE5.00X000
JOSEPH AMBROSI
TRUSTEE5.00X000
MICHAEL SHARPE
TRUSTEE5.00X000
TERRY GONZALES
TRUSTEE5.00X000
FieldValueIRS element (for citing)
Total Reportable Comp From Org0TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation0TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K0TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
UFCW GROUP ADMINISTRATION LLC
1277 TREAT BOULEVARD 10TH FLOORWALNUT CREEKCA94597CONTRACT ADMINISTRATOR18216504
BLUE SHIELD OF CALIFORNIA
2170 TOWNE CENTER PLACEANAHEIMCA92806HEALTHCARE ADMINISTRATION7414273
MEDEXPERT INTERNATIONAL INC
1300 HANCOCK STREETREDWOOD CITYCA94063HEALTHCARE ADMINISTRATION1520041
INFORMED RX INC
2441 WARRENVILLE ROAD SUITE 610LISLEIL60532HEALTHCARE ADMINISTRATION1199424
DELTA DENTAL
100 FIRST STREETSAN FRANCISCOCA94105DENTAL ADMINISTRATION911798
FieldValueIRS element (for citing)
Number Of Contractors GT100 K15NumberOfContractorsGT100K

Program Service Revenue ProgramServiceRevenue (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
EMPLOYER CONTRIBUTIONS900099490918220490918220
PARTICIPANT CONTRIBUTN9000992109529921095299
COBRA SUBSIDY9000995656956569
FieldValueIRS element (for citing)
Total Program Service Revenue512070088TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column4889454TotalRevenueColumn
Exclusion$4,889,454ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities371073609Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities374583176Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities-3509567Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-3509567TotalRevenueColumn
Related Or Exempt Function Income-3509567RelatedOrExemptFunctionIncome

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
EARLY RETIREE REINSURA90009988256648825664
MEDICARE PART D90009970305477030547
PRESCRIPTION DRUG REBA90009954531065453106

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column650902TotalRevenueColumn
Related Or Exempt Function Income650902RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Other Revenue21960219TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column535410194TotalRevenueColumn
Related Or Exempt Function Income530520740RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$4,889,454ExclusionAmount

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total522424333Total

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total18195987Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total969447Total

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total675461Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total350852Total

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total182554Total

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total53295Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total15629Total

Insurance Insurance

FieldValueIRS element (for citing)
Total350900Total

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotal
HEALTHCARE ADMINISTRATI13259640
ACTUARIAL CONSULTANTS1082123
UNION LOCAL ADMINISTRAT617047
COMMUNICATION SERVICES588339

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total23602Total

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total558789209Total

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY53787107BOY
EOY38555983EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY41314753BOY
EOY44858291EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY77329866BOY
EOY128036481EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY141263823BOY
EOY49725952EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY15300137BOY
EOY18993517EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY328995686BOY
EOY280170224EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY409365BOY
EOY28233EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY152264027BOY
EOY128376700EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY152673392BOY
EOY128404933EOY
FieldValueIRS element (for citing)
Do Not Follow SFAS117XDoNotFollowSFAS117

Cap Stck Trst Prin Current Funds CapStckTrstPrinCurrentFunds

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Paid In Cap Srpls Land Bldg Eqp Fund PaidInCapSrplsLandBldgEqpFund

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Retained Earnings Endowment Etc RetainedEarningsEndowmentEtc

FieldValueIRS element (for citing)
BOY176322294BOY
EOY151765291EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY176322294BOY
EOY151765291EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY328995686BOY
EOY280170224EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses-23379015ReconcilationRevenueExpenses
Reconcilation Other Changes-1177988ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Total Of Book Value Land Buildings0TotalOfBookValueLandBuildings

Other Securities OtherSecurities

FieldValueIRS element (for citing)
Description103-12 ENTITYDescription
Book Value49725952BookValue
Method Of ValuationFMethodOfValuation
FieldValueIRS element (for citing)
Total Of Book Value Securities49725952TotalOfBookValueSecurities

Other Assets OtherAssets (4 entries)

DescriptionDescriptionBook ValueBookValue
ACCRUED INTEREST399143
CASH COLLATERAL FOR SECURITES ON LOAN6170916
PREPAID INSURANCE194228
REFUND, REBATES & SUBSIDIES12229230
FieldValueIRS element (for citing)
Total Book Value Other Assets18993517TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (5 entries)

DescriptionDescriptionAmountAmount
GROUP INSURANCE PREMIUMS PAYABLE$20,464,872
SELF-FUNDED BENEFIT CLAIMS PAYABLE$62,937,406
CLAIMS INCURRED BUT NOT REPORTED$38,040,000
LIABILITY TO RETURN COLLATERAL FOR SECURITIES ON LOAN$6,168,005
DUE TO OTHER TRUST FUNDS$766,417
FieldValueIRS element (for citing)
Total Of Amounts128376700TotalOfAmounts
Total Revenue535410194TotalRevenue
Total Expenses558789209TotalExpenses
Excess Or Deficit For Year-23379015ExcessOrDeficitForYear
Net Unrealized GL On Investments-1177988NetUnrealizedGLOnInvestments
Total Adjustments-1177988TotalAdjustments
Excess Or Deficit Per FS-24557003ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt535410194TotRevenueEtcAuditedFinclStmt
Revenue Not Rptd F9900RevenueNotRptdF990
Revenue Subtotal535410194RevenueSubtotal
Revenue Not Rptd On Fin Stmt0RevenueNotRptdOnFinStmt
Total Revenue Per Form990535410194TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt558789209TotExpensesEtcAuditedFinclStmt
Expenses Not Rptd F9900ExpensesNotRptdF990
Expenses Subtotal558789209ExpensesSubtotal
Expenses Not Rptd On Fin Stmt0ExpensesNotRptdOnFinStmt
Total Expenses Per Form990558789209TotalExpensesPerForm990

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (6 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
FORM 990, PART XI, LINE 2CTHE TRUST FUND HAS A SPECIFIC PROCEDURE IN PLACE FOR THIS NEW DISCLOSURE REQUIREMENT ON THE SCHEDULE R. THE ADMINISTRATOR HAS SENT OUT A QUESTIONNAIRE TO OBTAIN THE REQUIRED INFORMATION FROM THE CONTRIBUTING EMPLOYERS. THE ABOVE INFORMATION REPRESENTS WHAT THE TRUST FUND HAS RECEIVED TO DATE.
FORM 990, PART VI, SECTION A, LINE 3THE ORGANIZATION DELEGATES CONTROL OF MANAGEMENT DUTIES CUSTOMARILY PERFORMED BY OR UNDER THE DIRECT SUPERVISION OF THE OFFICERS, DIRECTORS, TRUSTEES, OR KEY EMPLOYEES TO THE CONTRACT ADMINISTRATOR.
FORM 990, PART VI, SECTION B, LINE 11THE BOARD VOTES TO GIVE AUTHORITY TO CHAIR AND SECRETARY PRIOR TO SUBMISSION, WITH THEM REVIEWING AFTERWARDS.
FORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC, UPON REQUEST.
FORM 990, PART XI, LINE 5:NET UNREALIZED LOSSES ON INVESTMENTS: -1,177,988.CHANGES IN NET ASSETS OR FUND BALANCES:
FORM 990, PART XI, LINE 2CTHE BOARD OF TRUSTEES ASSUMES RESPONSIBILITY FOR OVERSEEING THE AUDIT OF THE ORGANIZATION'S FINANCIAL STATEMENTS AND FOR SELECTING THE INDEPENDENT AUDITOR.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (14 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionDirect Controlling Entity NADirectControllingEntityNAControlled OrgControlledOrg
UFCW NORTHERN CALIFORNIA EMPLOYERS JOINT PENSION PLAN
1277 TREAT BLVD 10TH FLOORWALNUT CREEKCA94597946313554TO PROVIDE PENSION BENEFITS TO ELIGIBLE PARTICIPANTSCA401AN/A0
UFCW NORTHERN CALIFORNIA EMPLOYERS INDIVIDUAL ACCOUNT PLAN
1277 TREAT BLVD 10TH FLOORWALNUT CREEKCA94597680161773TO PROVIDE ANNUITY BENEFITS TO ELIGIBLE PARTICIPANTSCA401AN/A0
UFCW EMPLOYERS BENEFIT PLANS OF NORTHERN CALIFORNIA GROUP ADMIN
1277 TREAT BLVD 10TH FLOORWALNUT CREEKCA94597260048379TO PROVIDE ADMINISTRATIVE SERVICES TO VARIOUSCAN/A0
TRI-WAY FREEZER MEATS
470 TRES PINOS RDHOLLISTERCA95023941541507CA0
UNITED WORKERS FEDERAL CREDIT UNION
3545 JAMISON WAYCASTRO VALLEYCA94546941476902FINANCIAL SERVICES - NON PROFIT COOPERATIVECAFEDERAL CREDIT UNION0
CALIFORNIA COMMUNITY CREDIT UNION
8815 FOLSOM BLVDSACRAMENTOCA95826941175532FINANCIAL SERVICESCA501C0
SAFE AMERICA CREDIT UNION
6001 GIBRALTAR DRIVEPLEASANTONCA94566941664405FINANCIAL SERVICESCA501C0
CALAVERAS COUNTIES CENTRAL LABOR COUNCIL
115 N SUTTER ST SUITE 200STOCKTONCA95202940376382LABOR COUNCIL - REPRESENTS LOCAL UNIONSCA501C0
BUILDING AND CONSTRUCTION TRADES COUNCIL
2300 TULARE STREET STE 150FRESNOCA93721941558907LABOR SERVICE ORGANIZATIONCA501C0
UNITED FOOD AND COMM'L WORKERS UNION LOCAL 5
240 SOUTH MARKET STSAN JOSECA95113208028546CA501C0
UNITED FOOD AND COMMERCIAL WORKERS
2200 PROFESSIONAL DR SUITE 150ROSEVILLECA95661940801845LABOR UNIONCA501C0
UNITED FOOD AND COMMERCIAL WORKERS UNION LOCAL 480
2305 SOUTH BERETANIA STREETHONOLULUHI96826990110735LABOR UNIONHI501C0
UNITED FOOD & COMMERCIAL WORKERS LOCAL 648
1980 MISSION STSAN FRANCISCOCA94103940525380LABOR ORGANIZATIONCA501C0
UFCW REGION 8 STATES COUNCIL
8530 STANTON AVE SUITE 2ABUENA PARKCA90620330453517LABOR ORGANIZATIONCA501C0

Form990 Schedule R Part III Form990ScheduleRPartIII (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateDisproportionate AllocationsDisproportionateAllocationsGeneral Or Managing PartnerGeneralOrManagingPartner
YOUNG'S SUPER MARKET
323 BIRCH STWESTWOODCA96137208366738RETAIL GROCERYCA00
SWAN OYSTER DEPOT
1517 POLK STREETSAN FRANCISCOCA94109SEAFOOD RETAIL/RESTAURANTCA00
DAVIS COWELL & BOWE LLP
595 MARKET STREET SUITE 1400SAN FRANCISCOCA94105941709555LAW FIRMCA00

Form990 Schedule R Part IV Form990ScheduleRPartIV (65 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateType Of EntityTypeOfEntity
UFCW EMPLOYERS BENEFIT PLANS OF NORTHERN CALIFORNIA GROUP ADMIN
1277 TREAT BLVD 10TH FLOORWALNUT CREEKCA94597260048379TO PROVIDE ADMINISTRATIVE SERVICES TO VARIOUS RELATED NORTHERN CA TRUSTSCAC
SAVE MART SUPERMARKETS
PO BOX 4278MODESTOCA95352941245496RETAIL GROCERYCAS
SAFEWAY INC
5918 STONERIDGE MALL RDPLEASANTONCA94588943019135RETAIL GROCERYCAC
SAFEWAY INC
5918 STONERIDGE MALL RDPLEASANTONCA94588381623900RETAIL GROCERYCAC
GROCERY OUTLET INC
2000 FIFTH STREETBERKELEYCA94710943210526RETAIL GROCERYCAC
DIABLO FOODS INC
PO BOX 1457LAFAYETTECA94549942233427RETAIL GROCERYCAS
LUNARDI'S SUPERMARKET INC
432 N CANAL ST SUITE 22SO SAN FRANCISCOCA94080942185885RETAIL GROCERYCAS
LUNARDI FOODS
432 N CANAL ST SUITE 22SO SAN FRANCISCOCA94080943151276RETAIL GROCERYCAS
BEST DEAL FOOD COMPANY INC
102 S 11TH AVEHANDORDCA93230770459122RETAIL GROCERYCAS
2040 FAIRFAX INC
101 PARKSHORE DR SUITE 100FOLSOMCA95630371576003RETAIL GROCERYCAS
MOLLIE STONE'S MARKET
150 SHORELINE HIGHWAY BUILDING DMILL VALLEYCA94941943052324RETAIL GROCERYCAS
VALLERGA'S DRIVE-IN MARKETS INC
2139 FIRST STNAPACA94559941411467RETAIL GROCERYCAS
DELUXE FOODS OF APTOS INC
783-25 RIO DEL MAR BLVDAPTOSCA95003RETAIL GROCERYCAC
NOVATO FOODS INC
155 SAN MARIN DRIVENOVATOCA94945200270166RETAIL GROCERYCAS
BIANCHINI'S MARKET INC
3130 ALPINE RDPORTOLA VALLEYCA94028943304815RETAIL GROCERYCAC
YOUNGS SUASE MARKET
323 BRICHST PO BOX 909WESTWOODCA96137208366738RETAIL GROCERYCA
SUSANVILLE SUPERMARKET
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FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg